A Higher Power: Religious Legacies in Popular Conceptions of Substance Use Disorder

Sam Keaser

Abstract This article traces theologies of individual and divine agency as they relate to faith healing throughout three cases in U.S. history—the milieu of faith healing movements at the end of the 19th century, Alcoholics Anonymous at its founding in the mid- and late-1930s, and a Pentecostal pastor’s work with New York City teenagers with substance use disorders (SUDs) in the 1950s and 1960s. Given the importance of religion in American life, faith healing’s role as a generator of theological innovation, and the persistence and dynamism of individual and corporate religiosity in the United States, it is argued that religious conceptions of health and recovery play an important role in the construction of social and political narratives.

Although not always and not at all times, this paper argues that one outcome of theologies of agency in relationship to healing and the divine is the popular assumption that people with substance use disorders who are not abstinent do so because they have made a conscious choice against such an option. This has ramifications for social understandings of SUDs, notions of what constitutes sobriety, and alcohol and other drug policy in the U.S. as the country works to address its ongoing opioid epidemic.

Biography Sam Keaser is a Master of Theological Studies student at Harvard Divinity School. He studies social theory and American evangelical politics.

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Introduction

Boston Mayor Marty Walsh recently came around in favor of safe injection facilities (SIFs), a harm reduction strategy in which people who use drugs are able to consume substances without fear of punishment and under the supervision of medical professionals. Even now, though, his support for SIFs is contingent on federal approval, which is unlikely to occur in the near-term.1

Mayor Walsh is a member of Alcoholics Anonymous (AA), a 12-step support program for recovering alcoholics. Some have drawn an explicit narrative connection between the two.2 AA’s central text, Alcoholics Anonymous, understands sobriety as complete abstinence, and Walsh’s past hesitance to support SIFs, so this narrative goes, is rooted in his adherence to AA’s understanding of sobriety—whatever the substance, the only path to sobriety and a normal life is complete abstinence. 3 AA, and not Walsh’s politics or other religious beliefs, is taken as the main reason he opposed SIFs.

This is part of a broader tendency in contemporary discourse to blame AA for public opposition in the United States’ to harm reduction strategies and medication assisted treatment

(MAT) options such as methadone and buprenorphine (also known as Suboxone). Gabrielle

Glaser’s 2015 Atlantic Article, “The Irrationality of Alcoholics Anonymous,” exemplifies this move.

“The 12 steps,” she writes, “are so deeply ingrained in the United States that many people…believe attending meetings, earning one’s sobriety chips, and never taking another sip of alcohol is the only way to get better.”4 Perhaps, but Glaser does not consider the broader

American religious context of which AA is only a part—and a relatively small part, at that. Blaming

1 Felice J. Freyer, “Walsh ‘absolutely 100 percent’ supports safe injection sites,” The Boston Globe, April 25, 2019 https://www.bostonglobe.com/metro/2019/04/25/walsh-absolutely-percent-supports-safe-injection- sites/xZIiWq6iRpBxtLuJpbQJLK/story.html. 2 See, for example: Britni De La Cretaz, The High and the Marty, DigBoston, https://digboston.com/the-high-and- the-marty/, July 28, 2018; it is also relatively common to hear this connection drawn in the Boston area recovery community. 3 Alcoholics Anonymous: “The Big Book,” The Original 29139 Edition, (Mineola, New York: Dover Publications, 2011), 33. 4 Gabrielle Glaser, “The Irrationality of Alcoholics Anonymous,” The Atlantic, April 2015; emphasis mine.

AA and other 12-steps programs for public opposition to MAT and harm reduction policies in the

United States both dehistoricizes and depoliticizes the abstinence-only notions of sobriety promoted by Christian groups in the United States with arguably more social and political influence than AA. By treating AA and 12-steps programs as unembedded in broader trends in

American religion, this narrative misses the context AA developed within and the ways in which this broader context is felt in American life today.

This essay considers three cases of faith healing milieus and movements throughout

American history with particular attention to the role individual and divine agency are understood to play in the healing process. It first looks at faith healing in the United States in the second half of the 19th century before turning to AA and its roots in the Christian Holiness traditions and finally to the 21st century federal government funding given to Teen Challenge, a nationwide addiction rehabilitation network started by a Pentecostal pastor in the 1960s. In particular, it considers the ways in which debates around the limits and reaches of human agency relative to God’s agency— debates that are ongoing and difficult to resolve within a Christian theological context—influence individual and social conceptions of sobriety. To understand public opposition to MAT and harm reduction strategies in the United States today, it is critical to understand the ways in which religion has and continues to play a role in defining millions of American’s conceptions of sobriety and agency when it comes to seeking and achieving recovery from substance use disorders

(SUDs).

Importantly, the focus of this essay is limited in scope. All of the subjects considered are white and the majority are men. While there is a coherent historical narrative to tell, the account that follows is partial and does not engage with the entirety of faith healing practices in the United

States. It should be read as such—as an account of one thread of the faith healing movement that points toward the eventual rhetorical and financial support by a U.S. president for a faith healing

based addiction treatment model. Several of the works cited here offer excellent accounts of faith healing that focus on or detail the role of women and gender in faith healing, such as Beryl Satter’s

Each Mind a Kingdom: American Women, Sexual Purity, and the New Thought Movement, 1875-

1920 and Heather D. Curtis’s Faith in the Great Physician: Suffering and Divine Healing in

American Culture, 1860-1900. Jonathan L. Walton’s “Liberation and the Prosperity Gospel,” in The

Oxford Handbook of African American Theology, is a useful reference text on the broad contours of some threads of Black American faith healing, spiritualist, New Thought, and prosperity traditions .

Religion in the United States

Although a growing percentage of Americans identify as religious “nones”—atheists, agonists, and those who believe “nothing in particular”—a strong majority of the country remains religious. In 2014, 70.6% of Americans identified as Christian and another 5.9% identified as belonging to a non-Christian faith.5 In terms of sheer numbers, religion is an important factor in

American life. Nonetheless, despite these high levels of religiosity in the United States, American historians sometimes do not fully consider the ways in which religion has and continues to play a role in shaping the society and politics of the United States outside of major, visible eruptions of religious faith and activity.

Religious historian Jon Butler’s “Jack-in-the-Box Faith: The Religion Problem in Modern

American History” examines exactly this problem. “After 1870,” Butler writes, “religion more often appears as a jack-in-the-box…[it] pops up colorfully on occasion in [U.S. history] textbooks.”6

These textbooks, however, “rarely connect American religious figures and events between 1870

5 Gregory Smith, et al., “America’s Changing Religious Landscape: Christians Decline Sharply as Share of Population; Unaffiliated and Other Faiths Continue to Grow,” Pew Research Center, May 12th, 2015, 3-4. 6 Jon Butler, “Jack-in-the-Box Faith: The Religion Problem in Modern American History,” The Journal of American History 90, no. 4 (Mar., 2004), 1359.

and 2000 to larger enduring patters in American life.”7 As an example, Butler critiques the lack of engagement with the religious character and explicitly religious history of the “post-1970 conservative Protestant political activism” of the Religious Right as a failure on the part of historians to understand modern American history in its own right.8 Importantly, his concern here is not the promotion of religion or using a religious lens to understand history; rather, what Butler is suggesting is that our understanding of modern American history is impoverished if scholars fail to integrate religion into their work. “[H]istorians,” Butler argues, “should grapple seriously with religion in modern American private and public life because doing less produces substantial misinterpretations of that history and the many peoples who made it.”9

Butler’s arguments on the secularization of American society are worth surfacing here. It is important, he notes, to not overstate the ubiquity of religious belief in the pre-Industrial United

States but also to emphasize the “remarkable persistence in twentieth-century America of an individual religious commitment so deep that it defies classification as privatized religion irrelevant to private life.”10 Moreover, not only has personal religious belief persisted, but throughout the 20th century Americans might have demonstrated institutional religious adherence at a level unseen in the country since the Massachusetts Bay Colony of the 17th century.11 Those corporate forms of religion were expressed in political and reform movements, such as the Civil

Rights Movement and the rise of the Religious Right.12 The United States has recently experienced a decline in adherence to institutional religion but the numbers of religious people in the United

States, the role religion has and continues to play in social and political movements, and the role

7 Ibid, 1359-1360. 8 Ibid. 9 Ibid, 1360. 10 Ibid. 11 Ibid, 1362. 12 Ibid, 1371-1372.

religion plays in the individual believer’s choice at the ballot box means that understanding

American history means taking seriously religion in the United States.

One attempt to trace the role of religion, and particularly Puritanical morality, in shaping

American society is James Morone’s Hellfire Nation: The Politics of Sin in American History.

Morone’s central argument is that the American story can be read as a “moral tale,” that the priority morality takes in American life is at least in part because Americans believe in God, and that this American morality results in the creation of a “redeeming ‘us’ and a reforming ‘them.’”13

The “us” being the moral ingroup, the group in power, and the “them” being anyone who actually or in the imagination of the ingroup violates the sense of morality of the ingroup. Similar to Butler,

Morone takes religion and religious belief as playing central roles in American history and politics.

In very broad strokes, for him, American political policy breaks down along two lines: the first or

Puritanical mode blames the sinner for their sin and so focuses on reforming the individual, the second or Social Gospel mode blames social sins for individual immorality and focuses on reforming society.14 In either case, some sense of morality is maintained in public policy—the redemption of the immoral individual remains key to both.

In a section on drug policy and harm reduction, Morone discusses the relationship between morality and drug use. Despite trends across the United States to favor treatment for substance use disorders (SUDs), he writes, “the neo-Puritan view still dominates [drug policy] debates: Drugs are wrong.”15 And the “classic moral view still stands, without apologies: Drug users are criminals.”16 Fair enough. It is difficult, if not impossible, to understand the relationship between religion and drug policy in the United States without a consideration of the ways that

13 James Morone, Hellfire Nation: The Politics of Sin in American History (New Haven, CT: Yale University Press, 2003), 3. 14 Ibid, 13-14. 15 Ibid, 472-474. 16 Ibid.

drug use is moralized by politicians, pastors, and voters. Nevertheless, the question remains why or how Americans moralize something, such as drug use, that is increasingly relegated to the medical realm and is broadly understood as not an individual choice in a robust sense. Stated as a question, what conceptions of agency produced by religious communities support the moralizing of SUDs and people who use drugs?

Christian Science, New Thought, and the Holiness Movement in the 19th Century

In a 2016 study, 66% of American adults reported believing that God can heal people supernaturally.17 87% of evangelical Christians—the largest group of Christians in the United

States, evangelicals profess a belief in a literal reading of the Christian Bible, the importance of individual conversion experiences, and social and religious activism—agree strongly that God can physically heal people. 95% of evangelicals have personally prayed for God’s healing.

Undoubtedly those who believe in faith healing almost certainly have different understandings of what that healing entails, whose agency is required for the healing, and what it means if someone prays for healing but is not healed. Nevertheless, belief in faith healing, defined here as any variant of the belief in supernatural healing, is alive and well in the United States. As will be seen, this belief in faith healing is rooted at least in part in histories that inform some popular conceptions of SUD.

The persistence of belief in faith healing might have come as a surprise, and certainly would have come as an annoyance, to the group of Chicago medical students who, in 1899, released noxious smelling gases during a faith healing service put on by John Alexander Dowie.18

In “Faith Healing, Medical Regulation, and Public Religion in Progressive Era Chicago” Timothy E.

W. Gloege documents the crusade of the respectable Protestant class against Dowie’s brand of

17 “Most American Believe in Supernatural Healing,” The Barna Group, September 29th, 2016, https://www.barna.com/research/americans-believe-supernatural-healing/. 18 Timothy E. W. Gloege, “Faith Healing, Medical Regulation, and Public Religion in Progressive Era Chicago,” Religion and American Culture: A Journal of Interpretation, 23, no. 2 (Summer 2013): 185.

faith healing. Ultimately, the issue with Dowie’s faith healing, as Gloege sees it, was not so much the belief that God might heal in some capacity, but, rather, that Dowie’s brand of faith healing was sectarian in the sense that it denounced the use of scientific medicine.19 Following the death of the child of one of Dowie’s followers in 1899, the Chicago Tribune published an article condemning Dowie’s faith healing beliefs.20 Later the same year, a woman died under the care of another of Dowie’s followers, Henrikka Bratz—again, the newspaper published an article condemning Dowie and Bratz. They highlighted Bratz’s explanation for the woman’s death, God’s anger at the lack of belief of her husband, as particularly objectionable.21 Moreover, Dowie began

“claiming that his ability to heal was evidence of a special divine authority.”22 Ultimately, Dowie was driven from Chicago by the threat and reality of physical violence.23

Dowie was certainly not alone as a faith healer in the United States during the second half of the 19th century. Christian Science and New Thought are two of the more prominent, non-

Christian variants.24 The former was first explicated by Mary Baker Eddy in her 1875 book Science and Health: With Key to the Scriptures and later institutionalized as the Church of Christ, Scientist.

The later was a less coherent movement that shared many theological similarities with Christian

Science—as Beryl Satter writes in Each Mind a Kingdom: American Women, Sexual Purity, and the

New Thought Movement, 1875-1920, “[b]oth believed that the mental or spiritual world was the true reality, while the material world of daily life…was merely a secondary creation of the mind.”25 In a similar vein, both believed in the creative powers of human thought and so also

19 Ibid, 204. 20 Ibid, 205. 21 Ibid. 22 Ibid, 204. 23 Ibid, 210. 24 Some Christian Scientists and Spiritualists would likely contest the notion that their traditions were non-Christian. While certainly true that both have historical roots in Christianity, both are at the very least heterodox if not heretical by traditional Christian standards and diverge in important ways from Dowie and the Holiness Movement, which will be discussed momentarily. 25 Beryl Satter, Each Mind a Kingdom: American Women, Sexual Purity, and the New Thought Movement, 1875- 1920 (Berkley: University of California Press, 1999): 3.

believed that “negative thoughts materialized into negative situations, while spiritual thoughts could form a positive reality.”26 Christian Science was founded by a woman, Baker Eddy, and many “New Thought followers understood themselves to be part of a women’s religious movement that would herald a new ‘woman’s era.’”27

There is a key difference, however, between New Thought and Christian Science’s conceptions of faith healing. While both stressed the importance of the individual mind in healing, for Eddy the existence of the “divine Mind” of God was a key component of her conception of healing in a way that it wasn’t for influential New Thought writer Warren Felt Evans.28 For Evans, in addition to the existence of God, the divine was found within each individual. For Eddy, the divine retained the external form of her era’s Christianity—a transcendent God who remained a critical component of the complete healing process.29 Nonetheless, despite this difference, for both, there is a role for a faith healer whose responsibility it is to telepathically convince their patients of the mental reality of disease. That is, of the fact that right thinking could lead to healing by making apparent to the sufferer of the disease that lack of its physical reality.30 Or, in the words of Baker Eddy, “[p]rayer to a corporeal God affects the sick like a drug, which has no efficacy of its own but borrows power from human faith and belief.”31 On the contrary, “[t]he adoption of scientific religion and of divine healing will ameliorate sin, sickness, and death.”32 Although healing prayer without Baker Eddy’s Christian Science might offer healing in the form of a placebo, an individuals’ right thinking is critical to her true healing.

26 Ibid, 3. 27 Ibid, 8. 28 Ibid; 66, 71. 29 Ibid, 4. 30 Ibid; 64-65, 71. 31 Mary Baker Eddy, Science and Health: With Key to the Scriptures (Boston: First Church of Christ, Scientist, 1994): 12. 32 Ibid, 141.

An important component of Protestant faith healing in the 19th century was Holiness theology. At the base of most Holiness thought, the historian George Marsden argues, was a definition of sin as “as a voluntary act of will.”33 Holiness sought to put forward a theology that supported the notion that Christian perfection—freedom from both the power of sin and the desire to perform sinful actions—was attainable in this life. Understanding sin as a voluntary act of will, however, meant understanding the lack of perfection as at least in part an expression of a lack of willpower or desire. To accommodate for this, and to continue stressing the absolute power of

God in the world, the ability of someone to freely choose to not sin, the Holy Spirit must

“completely overwhelm” their will.34 Importantly, this was an ongoing struggle throughout the life of the believer—it was possible to fall from the condition of perfection.35 Returning to faith healing, Heather Curtis writes in Faith in the Great Physician: Suffering and Divine Healing in

American Culture, 1860-1900 that “[t]he pervasive preoccupation with the pursuit of holiness…prepared the way for the rise of faith cure in the 1870s and 80s.”36 It did so by providing pre-existing networks to faith healers to travel upon and by emphasizing the ongoing process to overcome sin following a conversion experience and the individual’s role in that process.

Like Christian Science and Spiritualism, the broader movement of Christian faith healing had a larger presence of women in leadership positions than did the church or other para-church movements of the time.37 Curtis, though, cautions against readings of 19th century faith healing movements as primarily motivated by a desire for women to work against “the cultural norms and ideas that shaped their experiences of embodiment.”38 Curtis also suggests that faith cure, for all it

33 George Marsden, Fundamentalism and American Culture, 2nd ed. (Oxford: Oxford University Press, 2006), 73. 34 Ibid, 74. 35 Ibid. 36 Heather D. Curtis, Faith in the Great Physician: Suffering and Divine Healing in American Culture, 1860-1900 (Baltimore: Johns Hopkins University Press, 2007), 8. 37 Curtis, Faith in the Great Physician, 19. 38 Ibid, 19.

did to empower those who experienced divine healing, also “had a dark side…faith cure suggested that sick persons were somehow responsible for their condition and therefore suspect.”39

When healing failed, it was the individual and not the divine who was often blamed for her lack of health.

There are several strands of 19th century faith healings’ notions of agency worth teasing out. First, and mostly distinct from the other forms of faith healing to be considered, faith healing movements opened up positions of leadership for women they were denied within more traditional religious and other kind of organizations.40 Agency here, then, means something outside of the divine-individual relationship to heal. Straightforwardly, it is the agency of mostly white, middle-class women to take ownership of their own religious and faith healing experiences, even if that agency was not always articulated or understood as a way to work against established gender structures. Another important dimension of the question of individual agency in faith healing in the 19th century was that it remained contested both between and within traditions. It is difficult to make any claim to what a specific tradition believed regarding whose agency was primarily driving the healing process both because of ambiguities of the theologies of individual faith healers and the disagreements between practitioners within the same movement.

Finally, however, this ambiguity generally left open the possibility of whether an individual could be blamed for her own lack of healing. While direct lines from broad theologies to specific theological claims are often difficult to draw, some in the faith healing world explicitly connected their belief in the ability of God to heal and God’s desire to heal to a lack of healing as evidence of the individual’s failure of faith.41 For others, a failure to heal might represent less a failure of faith

39 Ibid, 24. 40 For more on the relationship between women, women’s rights, and Spiritualism, see: Ann Braude, Radical Spirits: Spiritual and Women’s Rights in Nineteenth-Century America, Second Edition (Bloomington: Indiana University Press, 2001). 41 Curtis, Faith in the Great Physician, 89.

and more a set of faulty assumptions—that God did not heal you in the way that you expected does not mean that God did not heal you.42 In any case, the onus was often put upon the individual when it came to her own health. That God could heal and that God was omnipotent did not mean not receiving healing was, or was only, God’s choice.

The Oxford Group and the Foundations of AA43

Drawing from Holiness theology, American evangelical preacher and theologian Frank

Buchman founded the Oxford Group in the early 20th century. The organization that would eventually help give rise to AA. Born in 1878, Buchman was directly responsible for the organization Moral Re-Armament, an outgrowth of the Oxford Group that retained the explicitly

Christian sensibilities of its precursor.44 Like both the Oxford Group and AA, Moral Re-Armament stressed the importance of individual experience and storytelling in the changing of human nature.45 In 1908, Buchman first encountered Holiness teachings at the Keswick convention, an annual gathering of Holiness Christians.46 From Keswick, Buchman took away an appreciation for personal encounters with Christ above and beyond an adherence to a specific theological orthodoxy.47 The individual conversion experience became the heart of the faith. Although not mentioned explicitly, for Buchman, as a member of the Holiness movement, it is likely that he

42 Ibid, 88. 43 There are ongoing debates around the analytic usefulness of the category “religion.” Placing AA in the same category as traditions and movements more explicitly associated with “religion” or “spiritual movements” is not meant an intervention into those debates nor is it a normative claim that AA is best understood as a religion. Rather, it is meant as a reflection of the language used by some early AA’s. For example, a pamphlet titled “Spiritual Milestones in Alcoholics Anonymous,” published by the original AA group in Akron, Ohio in the late 1930s or early 1940s, begins with the following: “[f]ew, if any, men or women have completely fulfilled the aims of Alcoholics Anonymous without at least some grasp of the spiritual, or…religion.”43 Later in the same paragraph, the author remarks that AA members who cannot “understand the spiritual angle” of AA take “the religion otherwise known as Alcoholics Anonymous [as] something complex, abstract, and awesome.”43 Following these AAs, then, this essay will refer to AA as both religious and spiritual. 44 Daniel Sack, Moral Re-Armament: The Reinvention of an American Religious Movement (New York: Palgrave MacMillan, 2009), 3. 45 Ibid, 3. 46 Sack, Moral Re-Armament, 10-11. 47 Ibid, 11.

understood conversion experience as one involving both the agency of the individual and the agency the divine.

Although preexisting its name, the Oxford Group was the title given to the South African variant of Buchman’s movement of individuals and groups working to evangelize at home and abroad.48 As Daniel Sack argues in Moral Re-Armament: The Reinvention of an American Religious

Movement the Oxford Group’s methods shared many similarities with early AA—it centered the sharing of personal stories and admitting powerlessness in the face of a negative force and, in response, giving yourself over to God.49 Of course, for the Oxford Group that God was the God of the Christian Bible. For AA, it was simply a Higher Power than oneself, the Christian God or otherwise.50

Alcoholics Anonymous, AA’s central text,51 makes it clear that “human resources, as marshalled by the will” are not sufficient for people with alcohol use disorder to stop drinking.52

Because of that, the early members of AA “had to find a power by which [they] could love, and it had to be A Power Greater Than [Themselves].”53 In fact, Alcoholics Anonymous claims that its

“main object is to enable you to find a Power greater than yourself, which will solve your problem.”54 This power does not, it is clear, need to be the Christian God but, at least according to the text, does need to have at least some spiritual dimension.55 “The great fact” of the solution to

48 Ibid, “A Quality of Life.” 49 Ibid, 83. 50 Ibid. 51 It is worth noting that however much insight a religion or spiritual movement’s central texts can provide, those texts never represent a tradition in its entirety. Even at the moment of their creation, religious texts hide disagreements between authors and are open to the interpretation of those who read them. This article, then, is not trying to make claims about the correct way to interpret AA’s central text, Alcoholics Anonymous. Likewise, it does not take the early texts of the movement as somehow more authentic or correct than later written and unwritten interpretations of Alcoholics Anonymous. Alcoholics Anonymous and the Akron pamphlets are used to provide a snapshot of AA thought at the moment of its founding and as a way to understand the relationship between AA’s conceptions of individual and divine agency relative to other movements and traditions. 52 Alcoholics Anonymous, “The Big Book,” The Original 1939 Edition (Mineola, NY: Dover Publications Inc, 2011.) 57. 53 Ibid, emphasis in original. 54 Ibid. 55 Ibid, 58-59.

alcohol use disorder is, according to Alcoholics Anonymous, “just this and nothing less” that we have had deep and effective spiritual experiences, which have revolutionized our whole attitude toward life, toward our fellows, and toward God’s universe.”56 “The metaphysical component, the

Higher Power, then, is a necessary part of the 12-step program prescribed by AA.

But what of those who attempt AA’s program, who attempt to engage with a Higher Power, and yet fail to attain sobriety? “Those who do not recover,” Alcoholics Anonymous says, “are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves.”57 It continues,

“[t]hey are not at fault; they seem to have been born that way.”58 Here, it seems like AA is giving its program, or perhaps individuals who fail to follow it for any number of reasons, something of an out. Nonetheless, later in the same chapter Alcoholics Anonymous still posits a strong role for agency of individuals who can pursue the 12-steps. AAs “launch” themselves “on a course of vigorous action” of personal housecleaning.59 And their “decision” to pursue sobriety was a “vital and crucial step” that would mean nothing without a “strenuous effort to face, and be rid of, the things in ourselves” that had blocked that sobriety. The action of the individual, then, is still critical to their success in the program. If they fail to act correctly, they will fail to stay sober.

AA’s conception of individual and divine agency as it relates to recovery from alcohol breaks down along several lines. First, as noted above, it is possible to read Alcoholics Anonymous as essentially making the claim that people who cannot find sobriety from alcohol are fundamentally and essentially unable to do so. No intervention from a Higher Power, apparently, can change that. Second, the role of the Higher Power in early AA texts is somewhat ambiguous.

Despite belief in a High Power being seen as necessary for sobriety, it seems as though the

56 Ibid, 35. 57 Ibid, 70. 58 Ibid. 59 Ibid, 76.

individual’s belief is the most critical part. Ultimately, an overwhelming High Power is needed to assist the alcoholic whose “so-called will power [has become] practically non-existent.”60 Yet, the belief in the Higher Power and the following through of the 12-steps requires individual will power—a “self-searching,” “leveling of…pride,” and a “confession of shortcomings.”61 The AA of

Akron’s “A Manual for Alcoholics Anonymous” is more direct: “Alcoholics Anonymous is one hundred percent effective for those who faithfully follow the rules. It is those who try to cut corners who find themselves back in their old drunken state.”62 In this way, AA’s conception of individual and divine agency bears a resemblance to Holiness theology—individual agency and powerless is preserved by naming an overwhelming Higher Power that makes possible the choice to act in such a way as to bring about sobriety.

Importantly, the notion of recovery in Alcoholics Anonymous is one of complete sobriety.

“Once [an alcoholic] takes any alcohol whatever into his system,” Alcoholics Anonymous claims,

“something happens, both in the bodily and mental sense, which makes it virtually impossible to stop.”63 An Akron pamphlet, “A Manual for Alcoholics Anonymous,” is more explicit—the aim of the group, it says, “is total and permanent sobriety.”64 Integrating AA’s belief in the individual’s ability to work through the 12-steps if they so choose, barring those who are naturally unable to, and their insistence on complete sobriety as the only form of recovery possible, it becomes at least plausible to think there might be certain political dimensions to these beliefs. If complete sobriety is attainable through AA’s program, and if those who fail AA’s program either cannot be honest with themselves and so move into recovery or lack the will-power to do so, then why should the state support drug rehabilitation or harm reduction strategies? Or, perhaps put more weakly, why

60 Ibid, 34. 61 Ibid, 35. 62 “A Manual for Alcoholics Anonymous: The Akron Manual,” (Akron, Ohio: Akron Area Intergroup, 1940). 63 Ibid, 33. 64 “A Manual for Alcoholics Anonymous”

should citizens be expected to pay taxes to support programs that are only needed because of a bad choice, or lack of the right choice, someone made of their own volition? Even if, of course, making that choice requires some interaction with the divine.

The Cross and the Switchblade: Pentecostalism and Teen Challenge

Pentecostalism, a Christian movement of increasing political and social importance in the

U.S. and globally, also draws from many of the same Holiness and faith healing legacies as AA.

Historian George Marsden dates Pentecostalism’s emergence as a “self-consciously distinct entity” to 1901.65 As a movement that stresses the importance of the ongoing presence of the Holy Spirt on the Earth, and so the continuation of miracles in the world up and until the present day, Grant

Wacker, an historian of 19th and 20th century American religion, sees healing through Christ as undergirding the Pentecostal revival, from Azusa Street to, in more recent years, an explosion of

Pentecostalism in the Global South.66 Additionally, Pentecostals believe in the active existence of the Biblical Spiritual gifts, such as speaking in tongues.67 Like American evangelicals, Pentecostals place a heavy emphasis on the individual conversion experience as the key to eternal salvation and the escape from eternal damnation. Given the emphasis on faith healing and the continuing action of the Holy Spirit in the lives of believers, that Pentecostalism emerged from the Holiness movement is perhaps not too surprising.68 Just over a century old, Pentecostals number around 500 million members worldwide and the tradition and its theology are increasingly influential on

American Christianity.69

65 Marsden, Fundamentalism, 72. 66 Jon Butler, Grant Wacker, and Randall Balmer, Religion in American Life: A Short History, 2nd ed. (Oxford: Oxford University Press, 2011), 294; “Pentecostal Growth,” The Atlas of Pentecostalism, accessed December 11, 2018, http://www.atlasofpentecostalism.net/cartography/item/0fd288150e92583bc9c1b4bd7ffeeaf9. 67 Butler, Wacker, and Balmer, Religion in American Life, 314. 68 Marsden, Fundamentalism and American Culture, 69 “Pentecostal Growth,” The Atlas of Pentecostalism

The Cross and the Switchblade details Pentecostal Pastor Dave Wilkerson’s work with teen gang members in New York City, many with SUDs. Written by Wilkerson in 1963, the book sold over 15 million copies and was later made into a movie. The Cross and the Switchblade begins with a discussion of Wilkerson’s early attempts to engage with gang members in New York at a time when he was a pastor in Central Pennsylvania. He recalls reading a story about a gang member on trial for murder in Life magazine, crying at the story, and then hearing the voice of

God telling him to “Go to New York City and help those boys.”70 Wilkerson did just that and, although struggling to do so at first, the book is largely a narrative of his success in converting members of gangs and other wayward youth in New York City to his brand of Christianity. A significant portion of the latter half of the book is dedicated to his work with teenagers experiencing SUDs to heroin and other drugs.

When it comes to the possibility of medical treatment for SUDs, Wilkerson is quite straightforward: “medicine does not have an answer to drug addiction.”71 Later in the book, he acknowledges that there are some medical spaces where “an addicted boy can get help” but that only one such location, Riverside Hospital, exists in New York.72 The only other option for treatment was “a forbidding-looking federal institution in Lexington, Kentucky,” presumably the

U.S. Public Health Service Hospital.73 Wilkerson’s feelings about the rate of SUDs in those he ministered to is not despair at the lack of treatment, however, but rather hopefulness at what the work of the Holy Spirit can do.

“The tremendous hold that drugs have on the human body,” Wilkerson begins a chapter,

“cannot be explained in physical terms alone.”74 He goes on to say that he believes “the devil”

70 David Wilkerson, John Sherrill, and Elizabeth Sherill, The Cross and the Switchblade (New York: Random House, 1963), 3-4. 71 Ibid, 32. 72 Ibid, 59. 73 Ibid. 74 Ibid, 188.

had people experiencing SUDs in his grip—and, of course, spiritual problems call for spiritual solutions. Unsurprisingly under this understanding, when Wilkerson tried to help a boy with a

SUD who had not yet converted he was unsuccessful. It was, as another boy reported, the baptism of the Holy Spirit, or here the conversion experience, that led him to “complete victory” over addiction.75 Describing the conversion experience of yet another boy with a SUD, Wilkerson reports that he responded to a preacher’s call for him to come up front, to make the decision to receive the Holy Spirit, before detailing the overcoming of the boy by the Spirt.76 But, Wilkerson wants to make clear, that he “cannot claim a magical cure for dope addiction.”77 He is, however, in the middle of a “bold experiment” and every day learns “how to make [his] role more effective, how to increase [his] percentage of permanent cures.”78

One outcome from Wilkerson’s experiment was Teen Challenge (TC). The largest drug treatment program in the United States as of 2010, in the same year TC residential treatment centers were located in more than 80 countries.79 Wilkerson purchased the Brooklyn building that would become the first TC center at the end of 1960.80 Following Wilkerson’s theology, the TC recovery program completely rejects the medical model of substance use disorder and requires complete abstinence from drug and alcohol use.81 Describing the organization in an article on

Presidential George W. Bush’s faith-based social initiatives, Joseph Loconte favorably writes that

TC’s philosophy of SUDs is that issues “such as drug and alcohol abuse are symptoms of a deeper ethical and spiritual malaise.”82 “Addiction,” moreover, “is considered a choice [by TC]—or a

75 Ibid, 192-193. 76 Ibid, 201-202. 77 Ibid, 206. 78 Ibid, 207. 79 Melissa R. Miller, “Adolescent Teen Challenge Program: An Evaluation of Efficacy” (PsyD diss., The Chicago School of Professional Psychology, 2013), 5. 80 Ibid, 131. 81 Ibid, 5-6. 82 Joseph Loconte, “Faith Healing,” Public Interest 155 (Spring 2004): 97.

series of choices—to ignore God and His call on one’s life.”83 “The religious understanding,” pursued by TC, “is that man is a moral actor, capable of making decisions for which he is ultimately responsible to God.”84 The year-long stay that the TC program prescribes is offered free of cost to people with SUDs.85

Interestingly, one of former President George W. Bush’s favorite faith-based social initiatives was TC.86 Bush, a 1999 story from the Washington Post reported, is a recovering alcoholic who “takes pride in saying that he never went into a substance abuse program such as

Alcoholics Anonymous.”87 He does, however, feel as though “he was guided by the broader AA philosophy of placing one’s faith in God.”88 An evangelical Christian, he achieved sobriety by changing his heart and through “an intense reawakening Christian faith.”89 That belief in the power of faith in God would later be made manifest in a promised, although never fully delivered upon,

$200 million in funding for faith-based drug-treatment social initiatives, such as TC.90 At least as described in the Washington Post article, Bush’s personal experience with an alcohol use disorder and his recovery from it closely parallels TC’s conception of SUD treatment. At the very least,

Bush’s vocal and specific support for TC represent a tacit endorsement of the legitimacy of TC’s approach to SUD treatment. An approach with resemblances to AA and some 19th century theologies of faith healing.

Historian Darren Dochuk’s treatment of evangelical theology and politics in From Bible

Belt to Sunbelt is useful here in illuminating the an ideological underpinning between faith healing and federal funding for TC. Dochuk traces the migration of “plain folk” from the western South—

83 Ibid, 98. 84 Ibid. 85 Ibid, 98-99. 86 Ibid, 89. 87 Lois Romano and George Lardner Jr., “Bush’s Life-Changing Year,” The Washington Post, July 25, 1999. https://www.washingtonpost.com/wp-srv/politics/campaigns/wh2000/stories/bush072599.htm. 88 Ibid. 89 Ibid. 90 Ibid, 91; Butler, Wacker, and Balmer, Religion in American Life, 434.

including Arkansas, Texas, and Oklahoma as well as bordering regions—to Southern California and the ways in which their populist politics came to dominate American evangelicalism.91 A populism that “exhibited a general hostility toward any aristocracy of ‘wealth, privilege, or political preferment’” and came with “an ingrained assumption of white racial superiority and the blessedness of small government and the ‘common man.’”92 Their religion was similarly democratic, populist, and opposed to elite intervention.93 While opposed to any state intervention into Protestant churches, these evangelicals also “rejected the notion that religious influence should be cordoned off from the state” and saw their role as the “last great vanguard” of “Christian democracy.”94 Both their politics and their religion were active and participatory. Seeing the role of the state as limited to domestically providing “security for hearth and home” they took it as the role of the church, Christians, and individuals to deal with social problems and many understood government programs such as the social welfare system as “suppressing the spirit of individualism” they held dear.95 State funding for programs run by Christians and focused on individual transformation, then, can be fine; however, government run programs that do not target the individual conscience—say, programs that offer MAT without a Christian component—remain suspect.

Taken together, Wilkerson’s work with TC can be understood in somewhat similar terms of a bridged or broken down divide between religion and politics. Called by God to do so, he exhibited a voluntarist drive to provide treatment to teens and others with SUDs. Treatment here, though, not being from federal hospitals or state supported clinics and not being particularly

91 Darren Dochuk, From Bible Belt to Sunbelt: Plain-Folk Religion, Grassroots Politics, and the Rise of Evangelical Conservatism (New York: W.W. Norton and Company, 2011), “Plain Folk.” 92 Ibid, 9. 93 Ibid, 13-17. 94 Ibid, 16-17. 95 Ibid; 9, 227; for an extended example of the evangelical belief in individual change as opposed to government programs as central to solving broader social ills, see Dochuk’s discussion of E.V. Hill’s response to racism on pages 287-291.

medicalized. Instead, treatment is understood as an individual choice insofar as one can choose to convert to Christianity. In doing so, one will be healed. Government intervention, then, is ultimately unnecessary. An exception here being federal support for programs like TC that emphasize individual change and the attendant chosen sobriety in the SUD recovery process. And expensive attempts to create more robust SUD treatment system by the federal government can be understood religiously and politically as unnecessary and undemocratic. This is rendered even more true when governmental programs do not offer individual Christian conversion as a solution to SUD. Why limit an option whose success rate is, for Wilkerson and others, significantly higher than the alternatives? The state in this case is essentially seen as wasting money.

It is critical not to misunderstand Wilkerson as acting capriciously towards people with

SUD. His opposition is not to outside assistance for people per se—indeed, his work with teenagers with SUD and his founding of TC indicate his own willingness to assist those with

SUD—but to top down state intervention that ignores the, for him, critical issue of personal and spiritual change in recovery from SUD. TC did not, in fact, turn down government funds. Although the data do not bear out his and TC’s opposition to MAT, and while some of that opposition may not always be in good faith supportive of people with SUD, at least some of their rejection of more medicalized variants of treatment can and should be read as a sincerely held belief in the necessity of personal transformation through a conversion to Christianity. While this sincerity does not negate the damage done by opposition to MAT and a systemic conception of the various underlying causes of SUD, it is a sincerity worth understanding in order to better grasp the political position of many Americans today.

Wilkerson’s theology of faith healing and TC’s philosophy of SUD treatment—as with many of the 19th century faith healers explored and with AA—can be used to blame those who continue to struggle with SUD for that struggle. It also renders expensive state interventions into

SUD treatment effectively a waste of money because in light of this theology individuals with

SUDs can be healed if they choose to convert. Not presenting them with that option and instead spending money building out an infrastructure that does not center individual choice, for

Wilkerson and many other evangelicals, is nonsensical. If addiction is seen as a choice, and medical treatment for SUDs rejected, it is relatively clear that individuals who make the choice to continuing using substances are to blame for their situation. While God, and more specifically the conversion experience, is ultimately responsible for people recovering from SUDs, it is ultimately up to the individual to step towards the altar and receive the baptism of the Holy Spirt. That an organization, TC, with explicitly this theology received funding from the federal government is indicative of the role that faith based organizations and philosophies can and do have on

American politics.

Conclusion

On November 28th, 2018 Liberty University held a townhall conversation on the opioid crisis. First Lady Melania Trump headlined the event, which doubled as a pilot episode for former

Fox News host Eric Bolling’s television show “America.”96 The event began with prayer. In it, the speaker acknowledged the importance of the opioid crisis to God and to individual Liberty students in the audience. He also asked God for hope and for a strategy to address the opioid crisis. Following the prayer, Liberty University President Jerry Falwell Jr. told the story of how the event came together—Bolling wanted to speak with the President or First Lady for the first episode of his new show. Falwell’s wife, Becki, offered to text the First Lady and ask her to appear. She said yes. After Bolling interviewed the First Lady about her own work on the opioid crisis, U.S.

Secretary of Homeland Security Kirstjen Nielson and U.S. Secretary of Health and Human Services

96 “Melania Trump joins cabinet leaders to shed light on opioid crisis,” Liberty News, November 28, 2018, http://www.liberty.edu/news/index.cfm?PID=18495&MID=296446.

Alex Azar joined Bolling, Trump, and Jerry and Becki Falwell to field students questions about the epidemic.

With more than 100,000 students who take courses online and on campus, Liberty

University is one of the largest Christian universities in the world.97 Deeply evangelical and politically conservative, Liberty has become an increasingly important site in Christian higher education in the United States. Texas Senator Ted Cruz announced his 2016 presidential campaign at Liberty and Republican nominee Mitt Romney gave a speech at the school during his

2012 presidential campaign.98 Falwell, the University’s President, spoke at the 2016 Republican

National Convention. The following year, President Donald Trump gave Liberty’s 2017 commencement speech. Liberty has established itself as a central player in 21st century

Conservative politics.

During his conversation with the First Lady at Liberty, Bolling commented on the tendency of some media outlets to focus on ostensibly less important things than the opioid epidemic because of, as he sees it, the media’s fixation on and opposition to the Trump administration. He cited the controversy over the First Lady’s decision to put red Christmas trees up in the White

House. To their credit, The New York Times published an article that mentioned Liberty’s town hall; however, it failed to mention the subject of the event. Instead, published in the “Style” section, it focused on First Lady’s defense of her red Christmas trees.99 Perhaps Bolling is onto something. More likely, though, the lack of coverage, but not knowledge, of the substantive political issues covered at Liberty’s town hall has less to do with the media’s bias against the

97 Jack Jenkins, “Liberty University is no longer the largest Christian university,” Religion News Service, April 27th, 2018, https://religionnews.com/2018/04/27/liberty-university-is-no-longer-the-largest-christian-university/. 98 Nick Anderson, “Virginia’s Liberty University: A mega-college and Republican presidential stage,” The Washington Post, March 23rd, 2015, https://www.washingtonpost.com/news/grade-point/wp/2015/03/23/virginias- liberty-university-a-mega-college-and-republican-presidential-stage/?utm_term=.8d23bd7074c9. 99 Steven Kurutz, “There Will Be Blood-Red Trees,” The New York Times, November 30th, 2018, https://www.nytimes.com/2018/11/30/fashion/white-house-christmas-decorations.html.

Trumps than it does with a continuing misunderstanding of the relationship between faith and

American politics.

As with previous moments in the history of supernatural healing, Liberty University’s town hall demonstrated some amount of confusion over SUD, agency, and faith healing. During the event itself, Secretary Azar referred to SUD as a medical issue, not a moral failing.100 An interesting departure from the discourses around SUD in evangelical spaces.101 In a linked article in the

Liberty Journal, however, a Liberty student describes a conversion experience that, apparently, moved him into recovery. Following something similar to Holiness theology, he narrates his conversion as both his decision and also the power of God to act in the world. In this case, upon the demons of drug addiction.102

Outside of Liberty and of the explicit context of faith healing, conversations on the U.S. opioid epidemic continue in religious circles. The Southern Baptist Convention—the largest evangelical denominations in the United States, with more than 15 million members—released a resolution “On Opioid Abuse and Addiction” earlier in 2018. The resolution mostly focuses on the doctor prescribed opioids dimension of the epidemic, condemning the use of opioids outside of the direction of a physician and encouraging “the medical community, insurance, providers, healthcare providers, and pharmaceutical manufacturers to advocate for the prescription of opioids only under the most stringent standards.”103 Bible verses, from the acknowledgement that all people are made in the imagine of God to Christ’s commandment to love one’s neighbors, frame the resolution. It also includes an encouragement that “city, state, and national governments

100 “Melania Trump joins cabinet leaders to shed light on opioid crisis.” 101 And evidence that there may be room within the evangelical coalition for a politics of SUD that includes MAT. 102 Karen Kingsbury, “The Opioid Epidemic: Responding To a Crisis That is Gripping our Nation,” Liberty Journal, October 11th, 2017, https://www.liberty.edu/journal/article/the-opioid-epidemic-responding-to-a-crisis-that-is-gripping- our-nation/. 103 "On Opioid Abuse And Addiction, Dallas, TX – 2018," Southern Baptist Convention, Accessed September 25, 2018, http://www.sbc.net/resolutions/2292/on-opioid-abuse-and-addiction.

work together to address the crisis” and that churches support “families and organizations that advocate and care for children who homes have been impacted by opioid abuse.”104 As they have throughout U.S. history, churches continue to put forward views based upon, among other things, their theologies and readings of their holy texts—these views help shape the politics of both those who preach them and those who hear them.

Sincerely held beliefs about the role of God in the life of the individual and the nation play into ongoing debates on agency in the opioid crisis. Although understanding someone’s religious beliefs is never enough to fully grasp their entire worldview and political perspectives, we ignore a critical component of what drives an individual’s political, social, and medical opinions if we fail to engage with their theology. This can be seen in moments throughout American history, as women and men at the end of the 19th century, the members of AA in 1935, and Dave Wilkerson and TC articulated new and contested relationships between individual and divine agency within the context of faith healing and the body. As Americans continue to profess a faith in God or high power and attend church in high numbers, it is unlikely that the role religion plays in either the life of the individual or the life of the nation will change significantly in the near future. Where individuals hold that an individual can freely choose to stop using drugs, to recover from SUD on their own volition through a religious experience, one imagines that it will take a significant amount of persuasion to convince them that the federal government should be involved. This is especially true if that involvement is expensive. This is worth attention as policy makers draft public health legislation to address the opioid epidemic and politicians attempt to convince their constituents of the importance of increased governmental intervention and spending to address the inadequate supply of quality SUD rehabilitation treatment in the U.S.

104 Ibid.

In response, politicians and policy makers need to consider ways to frame their proposals in language that resonates with the many Americans whose religion influences their stance on

MAT and harm reduction strategies. While they should not compromise on widely available quality care, which integrates MAT and does not include a mandatory religious component, it is important to not overlook the actual and rhetorical role of the local—as a space of politics, community, and religion—in SUD recovery. That is, where possible, policy makers should work with local communities to ensure that their needs are being met and their culture respected while also not denying or restricting treatment to those individuals inside of those communities who seek non-religious and MAT based treatment. Although there are tensions here that cannot be resolved, the act of sincerely engaging with local communities on their own terms is worthwhile in its own right. So long as pastors and people in the pews continue to understand their religion as implicitly or explicitly articulating notions of sobriety and recovery from SUDs, U.S. policy makers need to be aware of how those beliefs play into local and national conceptions of SUD and drug use.

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